Life’s Essential 8 (LE8), developed to assess cardiovascular health, may also help stratify long-term type 2 diabetes mellitus (T2DM) risk in postmenopausal women. A prospective cohort study published in the Diabetology evaluated LE8 scores and incident T2DM in the Women’s Health Initiative (WHI). 

The analysis included 19,403 postmenopausal women enrolled in the Women’s Health Initiative (WHI) without baseline T2DM. Data were analyzed from 1993 through 2024. LE8 scores ranged from 0 to 100 and were categorized as low (0-49), moderate (50-79), and high (80-100) according to American Heart Association definitions.

During a mean follow-up of 16.3 years, 3,921 women developed T2DM. Compared with women in the lowest LE8 category, those in the highest category had a lower risk of incident T2DM (hazard ratio [HR] 0.43; 95% confidence interval [CI], 0.38-0.49). Each 20-point increase in LE8 score was associated with a lower T2D risk (HR 0.57; 95% CI, 0.54-0.60).

Among the individual LE8 domains, body mass index (BMI) and blood glucose showed the strongest associations with incident T2DM. Subgroup analyses showed greater T2DM risk reduction among Hispanic/Latina women (HR 0.46; 95% CI, 0.41-0.53) than among non-Hispanic women (HR 0.58; 95% CI, 0.55-0.62). No statistically significant interaction by race was observed.

The findings support LE8 as a framework for lifestyle-based T2DM prevention in postmenopausal women.